Practice development and economic effects.
WILLIAM L. LOMBARDI, MD, FACC, FSCAI, AND NOAH J. JONES, MD
Chronic total coronary occlusions (CTOs) remain one of the most challenging lesion subsets for the interventional cardiologist. Successful CTO revascularization can have a beneficial effect on long-term survival and relief of angina, and use of drug-eluting stents has significantly reduced target lesion revascularization.1-5 However, procedural and nonprocedural factors often dissuade interventionists from fully adopting CTO cases into their practice. These factors include high reocclusion rates, high complication rates, low procedural success, suboptimal reimbursement, and prolonged procedure times.
To our knowledge, there has been no published economic analysis of CTO interventions. The goal of this article is to provide a framework that will help the interested interventionist develop a successful CTO program. Considerations will be given to the economic impact that a dedicated CTO program may have on the hospital and individual practice.
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